It’s extremely well known that our antibiotics are failing us. Alexander Fleming noticed it from the very beginning. Improper use of antibacterial agents leads to improved bacterial resistance to the agent. Throughout the decades since Fleming’s discovery of penicillin, we have watched as diseases have slowly (or quickly, in some cases) developed resistance to one antibiotic after another. The speed with which they are developing resistance has nearly surpassed the rate with which we can develop new antibiotics. And our newest antibiotics are losing their efficacy faster than their predecessors. It’s a viscous cause and effect cycle which we seem destined to lose.

As I searched for interesting research on Cephalosporins this week, I was reintroduced to this scary fact from several recent articles discussing the plight of increased resistance throughout the world to some of our most potent antibitics. First, I found a letter from Peter Collignon and colleagues to the CDC journal, Emerging Infectious Diseases, about the over-use of third generation cephalosporins in poultry through Europe. Collignon cited an ever rising tide of resistant E. coli (G3CREC) across Europe and that G3CREC-related illnesses have already been associated with over 900 hospital bed-days needed to treat the resistant infections and even resulted in 21 deaths in the Netherlands! The strangest part is that most countries have a “prudent use” policy in place concerning medical delivery of many antibiotics. At the same time, however, farm and veterinary implementation of these policies are lagging far behind. With the high rate of gene similarity between the G3CREC in humans and poultry in samples taken throughout Europe, it’s easy to see why the practice of large scale inoculations is so dangerous.

In another part of the world, Bhasker Thakuria and Kingshuk Lahon continued the cry for better “prudent use” polices in developing nations like India. There, it is cost prohibitive to do a full biological screening of every infection or illness. Through the lack of antibiotic susceptibility resources and the lack of guidelines for more common diseases, there is also a prevalence in using state-of-the-art antibacterial agents, such as later generation cephalosporins, to treat every patient’s illness, regardless of their specific needs. Thakuria and Lahon issued a call to improve the empirical use of drugs like cephalosporins before they become completely obsolete in our war against disease.

Finally, there was an article written by Douglas Call and associates detailing the possibility that increased antibiotic resistance might be related not just to our over-use of the drugs, but the downstream destinations of those drugs. Call found that metabolites of third generation cephalosporins, such as ceftiofur, excreted from cattle can still persist and remain biologically active for up to 3 days at room temperature (or several weeks at 4°C). And since 70% of ceftiofur is excreted through urine within 24 hours of injection, there is a high rate of probability that it will affect bacteria in the surrounding soil. The eventual resistant bacteria reenters the cattle through their environment, resulting in further resistance down the chain.

Our irresponsible use of antibiotics have created a pothole in the road to healthier living. Our continued irresponsible use will only serve to widen and deepen the hole we’ve made, eventually leading to the complete ineffectuality of our “antibiotic age” and the resurgence of some of mankind’s greatest diseases. In truth, perhaps it is not so much that our antibiotics are failing us, but that we are failing our antibiotics.

Collignon, P., Aarestrup, F., Irwin, R., and McEwen, S. (2013) C. D. C. Human Deaths and Third-Generation Cephalosporin use in Poultry, Europe (letter). Emerging Infectious Diseases, 19 (8), 1339.

Thakuria, B., & Lahon, K. (2013). The Beta Lactam Antibiotics as an Empirical Therapy in a Developing Country: An Update on Their Current Status and Recommendations to Counter the Resistance against Them. Journal of Clinical and Diagnostic Research, 7(6), 1207-1214.

Call, D. R., Matthews, L., Subbiah, M., & Liu, J. (2013). Do antibiotic residues in soils play a role in amplification and transmission of antibiotic resistant bacteria in cattle populations?. Frontiers in microbiology, 4 (193).

Category Code: 79102